Kisu I, Kato Y, Yamada Y, Matsubara K, Obara H, Emoto K, Adachi M, Umene K, Nogami Y, Banno K, Kitagawa Y, Aoki D
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
Department of Transplant Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
Transplant Proc. 2016 May;48(4):1266-9. doi: 10.1016/j.transproceed.2015.12.105.
Clinical studies of uterus transplantation have been performed to treat uterine factor infertility. Because the uterus is a pelvic visceral organ, the method of perfusion for the procurement of vital organs from a brain-dead donor should be modified for removal of the uterus. Herein, we report the results of a preliminary study in cynomolgus monkeys of a new perfusion method for uterus transplantation with assumed procurement of a uterus from a brain-dead donor.
Cynomolgus monkeys were used; thoracolaparotomy was performed on the donor. A perfusion catheter was then placed into the unilateral femoral artery and/or external iliac artery. Cross-clamping was performed for the aorta under the diaphragm and the inferior vena cava was divided in the pleural space. The perfusion solution was then administered via the catheter to perfuse all organs in the abdominal cavity, including those in the pelvic cavity. After the perfusion, gross observation and histopathological examination of abdominal organs were conducted.
Gross findings showed that all abdominal organs turned white in all specimens, indicating favorable perfusion of the uterus and all other organs in the abdomen. Pathological findings showed that almost no hemocytes were observed in the vessels of each organ.
With perfusion via the femoral artery and/or external iliac artery, all organs in the abdominal cavity, including the uterus, could be perfused. It was suggested that this technique could be useful for uterus transplantation assuming the procurement of a uterus from a brain-dead donor.
子宫移植的临床研究已开展用于治疗子宫因素导致的不孕症。由于子宫是盆腔内脏器官，从脑死亡供体获取重要器官的灌注方法应进行改良以用于子宫切除。在此，我们报告一项在食蟹猴中进行的初步研究结果，该研究采用一种新的灌注方法用于子宫移植，假定从脑死亡供体获取子宫。
使用食蟹猴；对供体进行胸腹联合切开术。然后将灌注导管置入单侧股动脉和/或髂外动脉。在膈肌下方对主动脉进行交叉钳夹，并在胸腔内切断下腔静脉。然后通过导管给予灌注液以灌注腹腔内的所有器官，包括盆腔内的器官。灌注后，对腹部器官进行大体观察和组织病理学检查。
大体观察结果显示，所有标本中的所有腹部器官均变为白色，表明子宫及腹部所有其他器官灌注良好。病理检查结果显示，各器官血管中几乎未观察到血细胞。
通过股动脉和/或髂外动脉进行灌注，可以灌注包括子宫在内的腹腔内所有器官。提示该技术对于假定从脑死亡供体获取子宫的子宫移植可能有用。
